As of the July, 2022, release via CMS

HOLSTON VALLEY HOSP & MED CTR

CMS id: 440017
130 W. RAVINE, KINGSPORT TN 37662. County: SULLIVAN
System: BALLAD HEALTH
CBSA: Kingsport-Bristol, TN-VA

The 320-bed, acute-care hospital had $8,511,034 in net service to patients*, with a total profit margin of 7.67562% in fiscal year 2021, the latest year available.
It spent 4.33% of its operating expenses on uncompensated care and reported $10,900,423 in Medicaid shortfall.

* For more about Net Service to Patients and operating revenue, please the finance section below.

Note: Medians are from acute-care hospitals with "complete" fiscal years. For more about how we calculated medians and cost reports in general, please click here.

Details

	2017	2018	2019	2020	2021
# of days in fyear	365	365	365	366	365
Ownership	nfp	nfp	nfp	nfp	nfp
Acute beds Median	225 118	258 118	237 119.5	240 118	261 119
Total beds Median	290 162	325 162	316 162	306 162	320 163.5
FTEs Median	1,757.51 788.06	1,735.14 793.42	1,709.80 806.03	1,451.48 787.61	1,377.50 804.34

Finances As they appear in worksheet G3 of the cost reports.

Note: Net Patient Revenue is considered operating revenue, which means Net Service to Patients is considered operating profit. Click here for more about cost report financials

Hospital cost reports are an enormously complicated dataset. There are whole organizations and an offical CMS vendor dedicated to helping researchers work with the data.
It's important to understand that hospital financials in cost reports are not organized in the same as other sources such as annual financial reports to bond holders.

The biggest difference is the concept of operating revenue and profit. Net Service to patients (NS2P), which is the sum of net patient revenue minus operating expenses, is considered the equivalent of operating profit according to the Medicaid and CHIP Payment and Access Commission (MACPAC). See the last paragraph of "Primary Data Sources" on page 55 of Annual Analysis of Disproportionate Share Hospital Allotments to States (PDF).

That would make Net Patient Revenue = operating revenue.

All this makes things challenging when comparing what's reported in cost reports to other sources. It becomes clearer when you consider that, beyond the purpose of reimbursement, cost reports are a tool for policymakers trying to understand the financial situation of a hospital doing the tasks specific to hospitals.

In other words, while a facility with a division that formulates drugs might include earnings from that as operating revenue in their corporate annual result, this is not central to the operations of a hospital caring for patients and so it is counted as "other income." (See below the financials section for more on "other income")

The healthcare consulting firm HMP, in a former partnership with Modern Healthcare, did develop a formula for estimating operating revenue closer to what one might find in other sources. We no longer use this for the following reasons:

The measure was not widely used beyond HMP and Modern Healthcare. Many hospitals had their own internal estimates of operating revenue and profit.
Because of this, there was confusion when reporting operating results for individual hospitals. There was often pushback when a facility's internal numbers did not match what Modern Healthcare was reporting.
The formula includes revenue from portions of the "other income" section, which may also include non-operating revenue. HMP themselves point out in a caveat on their site that they cannot exclude all non-operating revenue from their measure.

HMP's operating measure has proven problematic in the past for our reporting and the partnership with them ended years ago. It's best to not use a measure that we alone cannot defend.

	2017	2018	2019	2020	2021
Net patient revenue ? Median	315,304,579 150,932,746	338,753,316 158,950,878	341,787,654 168,696,998	289,535,372 163,454,693	354,747,418 186,589,412
Operating expenses Median	330,616,255 149,311,209	357,917,757 156,110,414	335,479,445 164,890,568	314,790,017 166,516,854	346,236,384 180,120,888
Net income from service 2 patients (NS2P) ? Median	-15,311,676 -964,173	-19,164,441 -643,601.5	6,308,209 -116,254	-25,254,645 -5,025,862	8,511,034 -1,284,564
NS2P margin ? Median	-4.86% -0.62	-5.66% -0.29	1.85% 0.18	-8.72% -5.07	2.40% -0.88

Range* of Net Service to Patient (NS2P) margins

= NS2P margin for HOLSTON VALLEY HOSP & MED CTR compared to all** acute-care hospitals, from CMS cost reports.
Note: NS2P is considered operating margin by MACPAC. The chart below is interactive: click or touch to see more.

* Data range does not show outliers, which fall beyond the minimum and maximum of the range.
** From cost reports with complete fiscal years. Number of acute-care hospitals available to calculate medians:

2017	2018	2019	2020	2021
3,157	3,092	3,050	3,052	2,566

	2017	2018	2019	2020	2021
Other income* Median Click here to show/hide details	6,428,149 5,089,215	4,605,027 4,572,541	5,437,490 5,268,134	12,313,208 13,092,619	24,533,446 12,369,236
⊳ Line 6: Contributions ? ⊳ Median	1,676,834 224,999	25,798 199,009	-19,050 206,870.5	-12,000 194,343	-53,500 249,496
⊳ Line 7: Investments ? ⊳ Median	41,447 299,524	94,781 188,688.5	43,221 370,813	20,440 309,361.5	11,679 375,329
⊳ Line 8: Revenue from telephone service	NULL	NULL	NULL	NULL	NULL
⊳ Line 9: Revenue from tv and radio	--	--	--	--	--
⊳ Line 10: Purchase discounts	0	0	0	0	0
⊳ Line 11: Rebates and refunds of expenses	0	0	0	0	0
⊳ Line 12: Parking lot receipts	0	0	0	0	0
⊳ Line 13: Revenue from laundry and linen service	0	0	0	0	0
⊳ Line 14: Revenue from meals sold to emplyees and guests	1,058,528	0	521,630	673,443	0
⊳ Line 15: Revenue from rental of living quarters	0	0	0	0	0
⊳ Line 16: Revenue from sale of medical and surgical supplies	0	0	0	0	0
⊳ Line 17: Revenue from sale of drugs to other than patients	2	0	0	0	0
⊳ Line 18: Revenue from sale of medical records and abstracts	0	0	0	0	0
⊳ Line 19: Tuition (fees, sale of textbooks, uniforms, etc.)	69,156	0	0	0	0
⊳ Line 20: Revenue from gifts, flowers, coffee shops, canteen	301,855	0	571,794	19,410	0
⊳ Line 21: Rental of vending machines	72,815	0	100,493	64,895	37,426
⊳ Line 22: Rental of hospital space	1,830,409	0	1,627,056	1,679,157	1,712,124
⊳ Line 23: Gov appropriations ? ⊳ Median	0 1,017,693	0 983,261.5	0 1,173,286	0 1,987,202	0 1,597,664
⊳ Sum Line 24	1,377,103	4,484,448	2,592,346	9,867,863	22,825,717
Total income ? Median	-8,883,527 6,586,430	-14,559,414 6,767,106	11,745,699 8,419,950	-12,941,437 8,094,175	33,044,480 15,162,888
Non-operating expenses Median	-5 146,289.5	0 164,857	226,946 89,880.5	801,865 106,761	3,932,325 31,473.5
Net income Median	-8,883,522 6,043,842	-14,559,414 5,845,112	11,518,753 7,606,259	-13,743,302 7,283,041	29,112,155 14,957,241
Net margin Median	-2.76115% 4.62%	-4.24030% 4.42%	3.31737% 5.16%	-4.55305% 5.2%	7.67562% 9.25%

* About "Other income": Other income, or line 25 in worksheet G3, is the sum of lines 6 through 24. It includes three lines that are considered non-operating revenue - contributions, investments and government appropriations. Medians are included for these three lines. It also contains items that are not central to providing healthcare, such as revenue from parking or gift shops.
"Sum Line 24" is a special case. Called "Other (specify)" in the cost reports, CMS allows for this line to be "subscripted," or divided into sublines like 002400, 002401, 002402. And hospitals do that, up to 100 lines, to detail income (and sometimes negative returns) that are otherwise not covered in the previous "other" lines. Therefore, "Sum Line 24" is the sum of all the lines 24.

Range* of total profit (loss) margins

= Total margin for HOLSTON VALLEY HOSP & MED CTR compared to all** acute-care hospitals, from CMS cost reports.
The chart below is interactive: click or touch to see more.

2017	2018	2019	2020	2021
3,157	3,092	3,050	3,052	2,566

Medicare revenue

Inpatient and outpatient revenue

	2017	2018	2019	2020	2021
All inpatient revenue Median Click here to show/hide details	59,877,877 23,241,334	62,687,293 23,709,545	63,866,052 24,248,380	56,623,266 22,858,541	63,963,271 23,620,613
"All inpatient revenue" is made up of any Medicare payments for routine inpatient, swingbed SNFs, TEFRA, IPF, IRF, inpatient long-term care, CAH and inpatient SNF facilities. Medians are only calculated when there are sufficient facilities reporting revenue.
⊳ Routine inpatient revenue ⊳ Median	59,877,877 21,577,146	62,687,293 22,041,594	63,866,052 22,722,063	56,623,266 21,570,441	63,963,271 22,140,684
⊳ Swingbeds ⊳ Median	0 --	0 --	0 --	0 --	0 --
⊳ Tax Equity and Fiscal Responsibility Act payments (TEFRA) ⊳ Median	0 --	0 --	0 --	0 --	0 --
⊳ Inpatient psychiatric facility (IPF) ⊳ Median	0 1,845,420	0 1,757,392	0 1,738,842	0 1,510,463	0 1,393,140
⊳ Inpatient rehabilitation facility (IRF) ⊳ Median	0 3,535,627	0 3,746,588	0 3,782,288	0 3,865,578	0 3,983,889
⊳ Long-term care hospital (LTCH) ⊳ Median	0 --	0 --	0 --	0 --	0 --
⊳ Critical-access hospitals ⊳ Median	0 --	0 --	0 --	0 --	0 --
⊳ Skilled-nursing facilities (SNF) ⊳ Median	0 1,203,033	0 1,215,295	0 1,313,657	0 1,365,298	0 1,179,746
All outpatient revenue Median Click here to show/hide details	24,499,674 11,160,864	27,933,324 11,987,345	23,460,120 12,926,866	22,003,523 11,884,480	22,205,362 13,145,163
"All outpatient revenue" is made up of any payments for routine outpatient, HHA, CMHC, rural health and other federally-qualified health clinics. Medians are only calculated when there are sufficient facilities reporting revenue.
⊳ Routine outpatient revenue ⊳ Median	24,499,674 10,918,923	27,933,324 11,706,976	23,460,120 12,615,917	22,003,523 11,458,116	22,205,362 12,776,716
⊳ Home Health agencies (HHA) ⊳ Median	0 1,282,808	0 1,407,728	0 1,341,512	0 1,407,046	0 1,476,867
⊳ Community mental health clinics (CMHC) ⊳ Median	0 --	0 --	0 --	0 --	0 --
⊳ Rural health clinics ⊳ Median	0 618,038	0 697,279	0 690,232	0 684,010	0 670,558
⊳ Other federally qualified health clinics ⊳ Median	0 --	0 --	0 --	0 --	0 --

Other payments

Item	2017	2018	2019	2020	2021
Graduate Medical Education (GME) Median	5,394,719 3,284,314	5,552,939 3,250,551	5,567,696 3,386,837	5,225,512 3,360,806	5,737,348 3,508,953
Disproportionate-share hospital (DSH) Median	933,168 594,888	1,045,023 595,761	1,145,289 577,894	828,187 542,168	1,069,892 549,667
Outlier Median	1,019,483 582,572	716,486 538,116	864,561 212,434	34,128 126,559	110,313 139,139

Uncompensated care

Item	2017	2018	2019	2020	2021
Medicaid shortfall Median	6,139,443 3,662,910	11,510,166 3,730,911	9,160,955 4,081,319	10,398,185 4,643,908	10,900,423 4,389,147
Charity care Median	13,933,671 2,654,636	21,460,585 2,940,659	17,368,792 3,380,215	11,764,524 3,488,738	12,687,572 3,233,405
Uncompensated care (UCC) Median	22,886,620 5,147,790	23,738,184 5,337,617	19,712,054 5,711,082	13,408,941 5,923,418	14,999,169 5,508,107
UCC as a % of operating expenses Median	6.92% 3.24	6.63% 3.12	5.88% 3.21	4.26% 3.3	4.33% 2.86
Total shortfall/UCC Median	29,026,063 9,489,989	35,248,350 9,424,297	28,873,009 10,120,158	23,807,126 11,171,337	25,899,592 10,133,851

Labor costs

	2017	2018	2019	2020	2021
Total salaries Median	84,955,309 52,142,039	92,636,859 54,485,252	107,718,138 57,395,589	95,354,322 58,830,919	99,717,856 61,722,907
Salaries as a % of operating expenses Median	25.70 36.68	25.88 36.56	32.11 36.37	30.29 35.93	28.80 35.24
Intern, resident salaries* Median	567,188 2,598,592	251,283 2,686,824	0 2,753,773	0 2,937,156	0 2,909,848
Contract intern, resident salaries* Median	2,197,037 1,251,927	2,847,891 1,186,494	3,164,209 1,204,885	3,164,209 1,279,653	2,411,934 1,469,317
Contract adjusted salaries, direct-care Median	10,520,545 1,449,244	10,559,706 1,475,986	4,113,105 1,563,078	5,876,277 1,721,954	15,969,973 2,991,828
Contract hours, direct-care Median	245,196.00 22,725	232,386.00 23,018.5	60,195.29 24,503.48	85,130.97 25,026.5	175,243.32 33,786
Contract wages, direct-care Median	42.91 64.67	45.44 64.53	68.33 65.06	69.03 68.97	91.13 88.94

* in an approved program

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Cost reports are self-reported by the facility, are subject to revision and should be considered preliminary.

* Net Service to patients (NS2P) equals net patient revenue minus operating expenses. NS2P is considered the equivalent of operating profit according to the Medicaid and CHIP Payment and Access Commission (MACPAC). See the last paragraph of "Primary Data Sources" on page 55 of Annual Analysis of Disproportionate Share Hospital Allotments to States (PDF).

About medians

Medians are calculated from reports with "complete" fiscal years, or reports with fiscal years of at least 300 days and no more than 420 days.

In cases where there are fewer than 50 values reported, medians are not calculated. For childrens' hospitals, it's when fewer than 20 are reported.

Web app by Tim Broderick | email.